Neuroblastoma

Neuroblastoma is a rare cancer of the sympathetic nervous system. It affects usually young children, and is the most common cancer among infants. They are typically found in the adrenal glands (the organs sitting on the top of the kidneys) but they may begin in other nerve tissues in the neck, chest, abdomen or pelvis. They may also spread to other areas of the body, including bone and bone marrow, lymph nodes and the liver.

Treatment for neuroblastoma differs depending on many factors, particularly the stage of the disease and the age of the patient and the biologic factors determined after the biopsy (degree of differentiation, n-myc oncogene status and chromosome abnormalities). Some neuroblastomas will disappear without any treatment (in very young infants), and others can be cured by surgery alone (in early stages). Patients with large tumours with no metastases (spread to other parts of the body) and not biologically "aggressive" can be highly curable with 4-8 cycles of chemotherapy and surgery.

Approximately half of all neuroblastomas are found to have already spread to bone and bone marrow by the time they are diagnosed, and these tumours require more complex treatment. This usually includes a phase of intensive chemotherapy followed by surgery, radiation therapy, high dose chemotherapy with autologous bone marrow transplant, retinoic acid and anti-GD2 monoclonal antibody.

Unfortunately a significant number of patients with advanced disease at diagnosis experience re-growth of their tumour which is associated with a very poor prognosis. Patients with relapsed neuroblastoma are usually enrolled in available clinical trials or treated with novel chemotherapeutic/biological combination therapies.